A multicentre study of intentional behavioural responses measured using the Coma Recovery Scale-Revised in patients with minimally conscious state

Clin Rehabil. 2015 Aug;29(8):803-8. doi: 10.1177/0269215514556002. Epub 2014 Nov 7.


Objective: To investigate which conscious behaviour is most frequently detected using the Coma Recovery Scale-Revised in patients with minimally conscious state.

Design: Multicentre, cross-sectional study.

Setting: One intensive care unit, 8 post-acute rehabilitation centres and 2 long-term facilities.

Subjects: Fifty-two patients with established diagnosis of minimally conscious state of different aetiology.

Main measures: All patients were assessed by the Coma Recovery Scale-Revised.

Results: In most patients (34/52) non-reflexive responses were identified by two or more subscales of the Coma Recovery Scale-Revised, whereas in 14 patients only the visual subscale could identify cortically-mediated behaviours, and in the remaining 4 patients only the motor subscale did so.The clinical signs of intentional behaviour were most often detected by the visual subscale (43/52 patients) and by the motor subscale (31/52), and least frequently by the oromotor/verbal subscale (3/52) of the Coma Recovery Scale-Revised. This clinical pattern was observed independently from time post-onset and aetiology.

Conclusions: Non-reflexive visual behaviour, identified by the visual subscale of Coma Recovery Scale-Revised, is the most frequently detected intentional sign consistent with the diagnosis of minimally conscious state, independently from aetiology and time post-onset.

Keywords: Coma Recovery Scale-Revised; Minimally conscious state; brain injury; intentional behaviours; rehabilitation.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Communication
  • Cross-Sectional Studies
  • Eye Movements
  • Female
  • Humans
  • Intention*
  • Male
  • Middle Aged
  • Persistent Vegetative State / physiopathology*
  • Persistent Vegetative State / psychology*
  • Persistent Vegetative State / rehabilitation
  • Psychomotor Performance / physiology*
  • Recovery of Function / physiology*
  • Reproducibility of Results
  • Young Adult